Incidence of Multiple Sporadic Renal Cell Carcinomas in Patients Referred for Renal Radiofrequency Ablation: Implications for Imaging Follow-Up
AJR: 197, September 2011
Michael D. Beland, Farrah J.Wolf David J. Grand Damian E. Dupuy William W. Mayo-Smith
OBJECTIVE. The objective of our study was to report the incidence of multiple sporadic primary renal cell carcinomas (RCCs) in patients referred for radiofrequency ablation (RFA).
MATERIALS AND METHODS. A retrospective search identified 162 patients (104 men and 58 women; mean age, 74 years) without a history of von Hippel-Lindau disease with a total of 175 tumors treated with RFA for biopsy-proven primary renal malignancies at our institution from 1998 to 2009. Three groups of patients with multiple RCCs were identified: patients with a history of nephrectomy for RCC who had been referred for RFA of a new renal tumor, patients who presented with multiple renal tumors at the time of referral for RFA, and patients who were shown to have developed a new renal tumor on follow-up imaging after RFA.
RESULTS. Twenty-eight patients (17%) had multiple biopsy-proven RCCs. Eighteen patients (11%) had undergone prior nephrectomy for surgically proven RCC. The mean interval between prior nephrectomy and RFA referral was 122 months (range, 12-456 months). Seven patients (4%) without a history of nephrectomy presented with two biopsy-proven RCCs at RFA referral. Three patients (2%) who had not undergone nephrectomy and had a solitary RCC at the time of RFA had developed a new biopsy-proven RCC separate from the original treatment site on follow-up imaging after RFA. The mean time to diagnosis from the initial RFA treatment was 52 months (range, 25-89 months).
CONCLUSION. Imaging surveillance of patients referred for renal RFA may be important not only to assess treatment success but also to detect new RCCs.